OBJECTIVE To evaluate quetiapine as an adjunct to paroxetine in patients with comorbid depression and anxiety. METHOD Prospective, multicenter, single-blind trial of patients with DSM-IV major depression and associated anxiety, who were randomized to an 8-week treatment with paroxetine alone (n=54) or paroxetine+quetiapine (n=58). Quetiapine was dosed to 200 mg/day and paroxetine to 60 mg/day, as required. RESULTS Decrease in HAM-A scores was significantly greater in the combined therapy group than with paroxetine alone at weeks 2, 4, 6 and LOCF (P<0.008). Decrease in HAM-D scores was significantly greater in the combined therapy group than with paroxetine alone throughout the study period (P<0.008). Regarding adverse events, it was found that increases in anxiety and insomnia were more prevalent in the paroxetine only group, while increased appetite was more prevalent when quetiapine was added (P<0.05). CONCLUSION Quetiapine added to paroxetine is well tolerated and may speed up and improve response in patients with comorbid depression and anxiety.
Obsessive compulsive disorder (OCD) is a psychiatric disorder characterized by obsessive ideas and compulsive behaviors. Genetic studies have centered on candidate genes involved in OCD etiology related to serotonergic and dopaminergic systems. In this study, the relationship between cathechol-O-methyltransferase (COMT) -287A/G (rs2097063), serotonin transporters 5-HTTLPR I/D, and SLC6A4 rs16965628 polymorphisms in 80 OCD patients and 100 healthy controls was determined. Patients and controls were genotyped for COMT rs2097063 and SLC6A4 rs16965628 polymorphisms by real-time polymerase chain reaction (PCR). The 5-HTTLPR I/D polymorphism was genotyped using PCR and agarose gel electrophoresis. Severity of symptoms was checked with a Yale-Brown Obsession Compulsion Scale (Y-BOCS). When the OCD group and controls were compared, no significant difference was found between COMT -287A/G (rs2097063), 5-HTTLPR I/D polymorphisms, and OCD. However, a significant difference was found between 5-HTT rs16965628 polymorphism and OCD (p=0.025, OR=3.43, 95% CI 1.41-10.35). In addition, the G allele frequency was found to be higher for rs16965628 in the OCD group. No significant difference was observed between COMT -287A/G (rs2097063), SLC6A4 rs16965628, and 5-HTTLPR I/D polymorphisms and Y-BOCS scores (p>0.05). There was also lack of correlation between Yale-Brown scores and gender of OCD patients. On the other hand, combined genotypes of SLC6A4 rs16965628 GG+GC were found to be risk factors for OCD development (p=0.02, OR=3.464; 95% CI 1.214-9.883) in logistic regression analysis adjusted for age and gender. Our findings suggest that subjects carrying the G allele of rs16965628 have genetic susceptibility to OCD. These data are the first to suggest that polymorphism in serotonin transporter (rs16965628) is associated with the development of OCD in the Turkish population.
The authors demonstrate that clozapine may be cautiously continued in selected patients who showed marked psychiatric improvement with clozapine in the face of liver enzyme elevation.
GPX1 Pro198Leu and OGG1 Ser326Cys polymorphisms were not associated with PD risk in Turkish patients. However, a gender-specific effect of GPX1 Pro198Leu C allele may be associated with PD development.
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